Medicare Basics:
The A, B, C and D’s of Medicare

Print this page | Contact us

There are four parts to Medicare:

Medicare Part A (Hospital Insurance)

Covers inpatient hospital care, inpatient skilled nursing facility care, hospice care and for some conditions, home health care. Medicare Part A has a deductible (d) that your must pay before any benefits (d) will be paid by Medicare. You will also be responsible for a per day copay (d) for extended hospital stays.

How much does it cost?

You don’t usually pay a monthly premium for Part A if you or your spouse paid Medicare taxes while working. If you didn’t pay enough Medicare taxes and you are age 65 or older or if you are disabled and have returned to work, you may be able to purchase Part A coverage. Contact Medicare for more information.

When to enroll

You are automatically enrolled the first day of the month you turn 65 if you get benefits from Social Security or Railroad Retirement Board (RRB). If you are under 65 and disabled, you will automatically be enrolled after the first day of the 25th month of your disability benefits from Social Security or RRB.

Medicare Part B (Medical Insurance)

Helps cover medically-necessary services like doctor office visits, outpatient care and some preventive services. There is an annual Medicare Part B deductible that you must pay before any benefits will be paid by Medicare. You will also be responsible for a coinsurance (d) amount for covered services (d).

How much does it cost?

Most people will pay <$00.00> per month for 2009. This is usually withheld from your Social Security Check. If your income is above $80,000 for an individual or $160,000 for a married couple, your monthly premium will be higher. Contact Medicare for more information.

When to enroll

You are automatically enrolled the first day of the month you turn 65 if you get benefits from Social Security or the Railroad Retirement Board (RRB). If you are under 65 and disabled, you will automatically be enrolled after the first day of the 25th month of your disability benefits from Social Security or RRB. If you don’t want to keep Part B, follow the instructions that come with your Medicare card and send the card back. You should receive this in the mail three months prior to your 65th birthday or your 25th month of disability benefits. If you keep your Medicare card, you keep your Part B benefits.

Some penalties apply if you do not enroll when you are first eligible and decide to enroll later. Your premiums may be higher. If you are not getting Social Security or RRB benefits you may enroll in Part B. Contact Medicare for more information.

Medicare Part C (Medicare Advantage)

Combines Part A, Part B and sometimes Part D prescription drug coverage (d) in one plan offered by a private insurance company with a Medicare contract. These plans must cover all the medically-necessary services Original Medicare Part A and B cover. However, these plans can charge different copays, coinsurance and deductibles for these services. These plans may also offer additional services that Original Medicare does not cover.

How much does it cost?

Premiums (d) and coverage vary by company and you must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party.

When to Enroll

First you must be enrolled in Medicare Parts A and B to enroll in a Medicare Advantage plan. Your initial election period for Medicare Advantage lasts for 7 months including the month you become eligible for Original Medicare and the three months prior and after the month you become eligible.

After this initial election period ends, you are locked-in to the plan you choose until the next Annual Coordinated Election Period or Open Enrollment Period.

It’s important to remember that you have an opportunity each year to change your Medicare Advantage plan. However, you can only change at certain times of the year. Please see Important Dates for Part C & D for more information.

Medicare Part D (Medicare Prescription Drug Coverage)

Medicare Part D standalone prescription drug plans help lower your prescription drug costs and help protect against higher costs in the future. These plans are offered by private insurance companies that contract with Medicare. These plans can be used with Original Medicare, Original Medicare and a Medicare Supplement Plan or a Medicare Advantage plan that does not include prescription drug coverage.

How much does it cost?

Premiums (d) and coverage vary by company. You may also qualify for extra help with your prescription drug plan premiums and copays. Please see Extra Help with Prescription Drugs for more details.

When to Enroll

First you must be enrolled in Medicare Parts A and B to enroll in a Medicare Part D prescription drug plan. Your initial election period for Medicare Part D lasts for 7 months including the month you become eligible for Original Medicare and the three months prior and after the month you become eligible.

After this initial election period ends, you are locked-in to the plan you choose until the next Annual Coordinated Election Period. It’s important to remember that you have an opportunity each year to change your Medicare Part D prescription drug plan. However, you can only change at certain times of the year. Please see Important Dates for Part C & D for more information.

Late Enrollment Penalties for Medicare Part D Coverage

If you do not enroll in a standalone Medicare Part D Prescription Drug plan or a Medicare Advantage plan with prescription drug coverage when you first become eligible or within 63 days of losing creditable coverage (d), you may have to pay a late enrollment penalty to join a plan later. This penalty is 1% of the current monthly premium amount for every full month you were without Medicare Part D prescription drug coverage. This amount is added to your monthly premium for as long as you have a plan.

Medicare Supplement (Medigap) Plans

This type of plan is private health insurance designed to fill in the gaps of what Original Medicare does not pay. Medicare Supplement plans, depending on the plan you choose can pay your Medicare Part A and B deductibles, copays (d) and coinsurance. Medicare Supplement plans are not part of the Medicare program however, they must follow federal and state laws designed to protect you. Medicare Supplement plans do not offer prescription drug benefits. To get prescription drug coverage you will need to enroll in a standalone Medicare Part D prescription drug plan. If you enroll in a Medicare Supplement plan, you should not enroll in a Medicare Advantage plan.

How much does it cost?

Premiums (d) and coverage vary by company. You will pay a monthly premium to the insurance company in addition to your Medicare Part B monthly premium.

When to Enroll

The best time to enroll is during the 6-month open enrollment period which begins the first day of the month you are both age 65 and enrolled in Medicare Part B.  You cannot be turned down for coverage during this time. You can enroll in a Medicare Supplement plan later, but some insurance carriers may require you to answer health questions and your acceptance in a plan is not guaranteed.

Explore Medicare Products from BlueCross BlueShield of Tennessee